LESS STRESS, MORE CARE

(Taking Charges of One’s Health)

STRESS AND HUMAN RESPONSE

The American Institute of Stress (AIS) has distinguished different types of stress and the human
response to it.

Hans Selye defined stress as the body's nonspecific response to any demand, whether it is caused
by or results in pleasant or unpleasant stimuli. It is essential to differentiate between the
unpleasant or harmful variety of stress termed distress, which often connotes disease, and eustress,
which often connotes euphoria. Eustress is stress in daily life that has positive connotations, such as
marriage, promotion, baby, winning money, new friends, and graduation. On the other hand,
distress is stress in daily life that has negative connotations such as divorce, punishment, injury,
negative feelings, financial problems, and work difficulties (AIS 2017).

During both eustress and distress, the body undergoes virtually the same nonspecific responses to
the various positive or negative stimuli acting upon it. However, eustress causes much less damage
than distress. This demonstrates conclusively that it is how an individual accepts stress that
determines ultimately whether the person can adapt successfully to change (AIS 2017).

Selye hypothesized a general adaptation or stress syndrome. This general stress syndrome affects
the whole body. Stress always manifests itself by a Syndrome, a sum of changes; and not by simply
one change (AIS 2017).

The general stress syndrome has three components:

1. The alarm stage -- represents a mobilization of the body's defensive forces. The body is
preparing for the "fight or flight" syndrome. This involves a number of hormones and
chemicals excreted at high levels, as well as an increase in heart rate, blood pressure,
perspiration, and respiration rate, among others.

2. The stage of resistance -- the body becomes adaptive to the challenge and even begins to
resist it. The length of this stage of resistance is dependent upon the body's innate and
stored adaptation energy reserves and upon the intensity of the stressor. Just as any
machine wears out even if it has been properly maintained, the same thing happens with
living organisms—sooner or later they become the victim of this constant wear and tear
process. The acquired adaptation is lost if the individual is subject to still greater exposure to
the stressor. The organism then enters into the third and final stage.

3. The exhaustion stage — the body dies because it has used up its resources of adaptation
energy. Thankfully, few people ever experience this last stage.

Stress diseases are maladies caused principally by errors in the body's general adaptation process.
They will not occur when all the body's regulatory processes are properly checked and balanced.
They will not develop when adaptation is facilitated by improved perception and interpretation. The
biggest problems with derailing the general stress syndrome and causing disease is an absolute
excess, deficiency, or disequilibrium in the amount of adaptive hormones. For example, corticoids,
Adrenocorticotropic Hormone (ACTH), and growth hormones are produced during stress.
Unfortunately, if stress is induced chronically, our defense response lowers its resistance since fewer
antibodies are produced and an inflammatory response dwindles (AIS 2017).

In the article "Understanding Stress Response" of the Health Harvard Journal (2017), it further
discussed chronic stress and human body response:

"Chronic stress is unpleasant, even when it is transient. A stressful situation—whether something

environmental, such as a looming work deadline, or psychological, such as persistent worry about
losing a job—can trigger a cascade of stress hormones that produce well-orchestrated physiological
changes. A stressful incident can make the heart pound and breathing quicken. Muscles tense and
beads of sweat appear."

This combination of reactions to stress is also known as the "fight-or-flight" response because it
evolved as a survival mechanism, enabling people and other mammals to react quickly to life-
threatening situations. The carefully orchestrated yet near-instantaneous sequence of hormonal
changes and physiological responses helps someone to fight the threat off or flee to safety.
Unfortunately, the body can also overreact to stressors that are not life-threatening, such as traffic
jams, work pressure, and family difficulties. Over time, repeated activation of the stress response
takes a toll on the body. Research suggests that chronic stress contributes to high blood pressure,
promotes the formation of artery-clogging deposits, and causes brain changes that may contribute
to anxiety, depression, and addiction. More preliminary research suggests that chronic stress may
also contribute to obesity, both through direct mechanisms (causing people to eat more) or
indirectly (decreasing sleep and exercise) (Health Harvard 2017).

The stress response begins in the brain. When someone confronts an oncoming car or other danger,
the eyes or ears (or both) send the information to the amygdala, an area of the brain that
contributes to emotional processing. The amygdala interprets the images and sounds. When it
perceives danger, it a distress signal instantly sends to the hypothalamus (Health Harvard 2017).

When someone experiences a stressful event, the amygdala, an area of the brain that contributes
to emotional processing, sends a distress signal to the hypothalamus. This area of the brain
functions like a command center, communicating with the rest of the body through the nervous
system so that the person has the energy to fight or flee. (Health Harvard 2017).
The hypothalamus is a bit like a command center. This area of the brain communicates with the
rest of the body through the autonomic nervous system, which controls involuntary body functions
like breathing, blood pressure, heartbeat, and the dilation or constriction of key blood vessels and
small airways in the lungs called bronchioles. The autonomic nervous system has two components
the sympathetic nervous system and the parasympathetic nervous system. The sympathetic nervous
system functions like a gas pedal in a car. It triggers the fight-or-flight response, providing the body
with a burst of energy so that it can respond to perceived dangers. The parasympathetic nervous
system acts like a brake. It promotes the "rest and digest" response that calms the body down after
the danger has passed (Health Harvard 2017).

After the amygdala sends a distress signal, the hypothalamus activates the sympathetic nervous
system by sending signals through the autonomic nerves to the adrenal glands. These glands
respond by pumping the hormone epinephrine (also known as adrenaline) into the bloodstream. As
epinephrine circulates through the body, it brings on a number of physiological changes. The heart
beats faster than normal, pushing blood to the muscles, heart, and other vital organs. Pulse rate and
blood pressure go up. The person undergoing these changes also starts to breathe more rapidly.
Small airways in the lungs open wide. This way, the lungs can take in as much oxygen as possible
with each breath. Extra oxygen is sent to the brain, increasing alertness. Sight, hearing, and other
senses become sharper. Meanwhile, epinephrine triggers the release of blood sugar (glucose) and
fats from temporary storage sites in the body. These nutrients flood into the bloodstream, supplying
energy to all parts of the body (Health Harvard 2017).

All of these changes happen so quickly that people are not aware of them. In fact, the wiring is so
efficient that the amygdala and hypothalamus start this cascade even before the brain's visual
centers have had a chance to fully process what is happening. That is why people are able to jump
out of the path of an incoming car even before they think about what they are doing. As the initial
surge of epinephrine subsides, the hypothalamus activates the second component of the stress
response system known as the hypothalamic pituitary adrenal (HPA) axis. This network consists of
the hypothalamus, the pituitary gland, and the adrenal glands. The HPA axis relies on a series of
hormonal signals to keep the sympathetic nervous system— the "gas pedal"—pressed down. If the
brain continues to perceive something as dangerous, the hypothalamus releases corticotropin
releasing, hormone (CRH), which travels to the pituitary gland, triggering the release of
adrenocorticotrophic hormone (ACTH – hormone in-charged to work properly and help your body
react to stress). This hormone travels to the adrenal glands, prompting them to release cortisol. The
body thus stays revved up and on high alert. When the threat passes, cortisol levels fall. The
parasympathetic nervous system—the "brake"-— then dampens the stress response (Health
Harvard 2017).
Persistent epinephrine surges can damage blood vessels and arteries, increasing blood pressure and
raising risk of heart attacks or strokes. Elevated cortisol levels create physiological changes that help
to replenish the body's energy stores that are depleted during the stress response. But they
inadvertently contribute to the build up of fat tissue and to weight gain. For example, cortisol
increases appetite, so that people will want to eat more to obtain extra energy. It also increases
storage of unused nutrients as fat. Chronic low-level stress keeps the HPA axis activated, much like a
motor that is idling too high for too long. After a while, this has an effect on the body that
contributes to the health problems associated with chronic stress (Health Harvard 2017).

TECHNIQUES TO COUNTER CHRONIC STRESS

Several techniques to counter chronic stress were presented in the same article (Health Harvard
2017):

1. Relaxation response. Dr. Herbert Benson, director emeritus of the Benson-Henry Institute for
Mind Body Medicine at Massachusetts General Hospital, has devoted much of his career to
learning how people can counter the stress response by using a combination of approaches
that elicit the relaxation response. These include deep abdominal breathing, focus on a
soothing word (such as peace or calm), visualization of tranquil scenes, repetitive prayer,
yoga, and tai chi.

Most of the research using objective measures to evaluate how effective the relaxation
response is at countering chronic stress have been conducted in people with hypertension
and other forms of heart disease. Those results suggest the technique may be worth trying,
although for most people it is not a cure at all. For example, researchers at the
Massachusetts General Hospital conducted a double-blind, randomized controlled trial of
122 patients with hypertension, ages 55 and older, in which half were assigned to relaxation
response training and the other half to a control group that received information about
blood pressure control. After eight weeks, 34 of the people who practiced the relaxation
response—a little more than half—had achieved a systolic blood pressure reduction of more
than 5 mm Hg, and were therefore eligible for the next phase of the study, in which they
could reduce levels of blood pressure medication they were taking. During that second
phase, 50% were able to eliminate at least one blood pressure medication—significantly
more than in the control group, where only 19% eliminated their medication.

2. Physical activity. People can use exercise to stifle the build up of stress in several ways.
Exercise, such as taking a brisk walk shortly after feeling stressed, not only deepens
breathing but also helps relieve muscle tension. Movement therapies such as yoga, tai chi,
and qi gong combined with fluid movements, with deep breathing, and mental focus, all of
which can induce calm.

3. Social support. Confidants, friends, acquaintances, co-workers, relatives, spouses, and

companions all provide a life-enhancing social net, and may increase longevity. It is not clear
why, but the buffering theory holds that people who enjoy close relationships with family
and friends receive emotional support that indirectly helps to sustain them at times of
chronic stress and crisis.

The cultural dimension of stress and coping

Ben Kuo (2010) reviews studies on cultural dimensions of stress and coping. His study, "Culture's
Consequences on Coping: Theories, Evidences, and Dimensionalities," published in the Journal of
Cross-Cultural Psychology had the following findings:

Stress and coping research constitutes one of the most intensively studied areas within
health, social, and psychological research because of its broad implications for
understanding human well-being and adaptation. Early thesis on stress and coping, the
interwoven relationship of culture and stress responses was implicated, conceptually. The
thesis postulated that a person's internalized cultural values, beliefs, and norms affect the
appraisal process of stressors and the perceived appropriateness of coping responses.
Accordingly, these cultural factors delimit the coping options available to an individual in the
face of stress. As follows, stress and coping are universal experiences faced by individuals
regardless of culture, ethnicity, and race, but members of different cultures might consider
and respond to stressors differently with respect to coping goals, strategies, and outcomes.

Kuo's study identified and revealed compelling evidence for cultural variations and
specificities on coping based on theoretical and empirical findings generated over the last
two decades' cultural coping research. Based on the broad problem-versus-emotion-focused
coping nomenclature, repeated studies have pointed to the prevalence of "emotion-
focused," "indirect," "passive," or "covert," "internally target," or "secondary control" coping
among individuals of Asian backgrounds, as well as, to a lesser extent, among individuals of
African and Latino backgrounds. Specifically, the avoidance, withdrawal, and forbearance
coping methods are common among Asians, while spiritual, religious, and ritualbased coping
are common among African-Americans and African-Canadians. Additionally, spiritual and
religious coping and coping through family support are common among individuals of
Latino/Latina backgrounds (Kuo 2010).

Furthermore, emotion-focused coping has been shown to be beneficial (e.g., reducing

distress) for Asian-Americans and Asian-Canadians in dealing with various stressors,
including family conflicts and racial discrimination. Problem-focused coping has also been
found to be effective for Asian-Americans and Asian-Canadians in responding to male gender
conflicts, racial discrimination, and cross-cultural adjustment. For non-Asians, emotion-
focused coping was shown to be negative in increasing stress for African-American adult
caregivers but problem-focused coping was shown to be negative in exacerbating stress for
Hispanic-American college students in facing family conflicts. As evident, the existing
knowledge on the adaptive quality of different coping strategies is currently incomplete and
inconclusive and necessitates further research (Kuo 2010).

The current review also highlighted the salience of "collective coping" approaches among
culturally diverse individuals, including Asians, African-Americans, and Latino-Americans,
based on more recent research. This distinctive domain of coping represents the collective
and interdependent characteristics of many ethnic minorities which is a critical aspect of
coping, overlooked by both the extant coping and the cultural coping literature until
recently. As has already been demonstrated in a number of recent published studies, to fully
represent and account for the coping system of ethnic minority individuals, an integrated
approach incorporating conventional and culture-based collective coping measures is
imperative (Kuo 2010).

Finally, this review also points to coping's link to: (a) broad societal climate, such as
collectivism-individualism and independent-interdependent cultural norms; (b) individuals'
acculturation and ethnic identity; (c) primary/internally versus secondary/extemally
controlled orientations; (d) accessibility and attitudes toward seeking social and family
support; and (e) degrees of religious/spiritual beliefs and identifications. Together, these
findings further underscore the significance of person-cultural environment interaction in
the coping process and provide corroborating evidence in support of the contextual and
transactional theories of coping (Kuo 2010).

However, the said syntheses need to be interpreted With caution in view Of several
limitations. First, it should be noted that the way in which types of coping were defined,
categorized, and measured varied quite significantly from study to study and would likely
have skewed the findings and the conclusions drawn and reduced the comparability across
studies.
 Second, the relationship between coping methods and coping outcomes is not
straightforward but is moderated by a constellation of contextual and personal factors as
suggested by the theoretical models reviewed earlier. Empirical data, in fact, have evidenced
the effects of a person's perceived "intensity" and "controllability" of the stressor and
cultural orientations (e.g., acculturation, self-construals) on coping. Lastly, it should be
recognized that an individual's actual coping system often comprises a complex and diverse
range of coping behaviors. For instance, Chinese-Canadian adolescents were found to
engage in collectivistically based coping, in conjunction with individualistically based coping
when dealing with interpersonal conflict, adjustment stress, and gender role-related stress.
Those qualitatively and functionally opposite coping strategies should not automatically be
construed as mutually exclusive within culturally diverse individuals (Kuo 2010).

Self-care Therapy

A positive way to counter stress is self-care therapy. Nancy Apperson (2008) of Northern Illinois
University has provided steps for self-care:

1. Stop, breathe, and tell yourself: "This is hard and I will get through this one step at a time. "
During an unexpected event or crisis, we are faced with dealing with a new reality and it
takes time to incorporate what happened into our everyday lives. Identify the steps you
need to take first, write them down, and focus on each step one at a time. If you look at
everything you have to do, you will become overwhelmed. Remember you can only do one
thing at a time and focus exclusively on that one thing.

2. Acknowledge to yourself what you are feeling. All feelings are normal so accept whatever
you are feeling. Once you recognize, name, and accept your feelings, you feel less out of
control. You can then find a comfortable place to express your feelings. During periods of
extreme stress and grief, it is very hard to hold back your feelings, particularly your tears and
anger. This is normal so describe this as grieving or sadness or anger. You are not falling
apart. You are grieving or feeling angry or sad. It is important during this time of intense
feelings to own your feelings and NOT hurt yourself or lash out at someone else.

3. Find someone who listens and is accepting. You do not need advice. You need to be heard.
Sharing our story is how we begin to accept whatever happened and integrate it into our
new reality. It may be that you just need to let go of your expectations of how things should
be and talking about your feelings and beliefs is the beginning of that process.

4. Maintain your normal routine as much as possible. Making everyday decisions—deciding to

get dressed, doing the dishes, or going to work—gives you a sense of control and feels
comforting as it is a familiar activity. Be realistic with what you can do and remember
everything right now will take you longer to do. Avoid making major decisions based on the
stress you feel right now.

5. Allow plenty of time for a task. You will not be as productive as you normally are. Accept
how much you are able to do right now and recognize it will not be this way During periods
of extreme stress, prolonged stress, or after a crisis, your ability to concentrate and focus on
tasks is diminished and it will take time for your concentration to return so give yourself
extra time and be gentle and accepting of yourself and what you can do.
 6. Take good care of yourself. Remember to:

a. Get enough rest and sleep. Sleep at least six hours and not more than nine hours. If you
are having difficulty sleeping, listen to peaceful or slow music and/or do progressive
relaxation before you go to sleep. Sleep helps our body heals and strengthens our
immune system.
b. Eat regularly and make healthy choices. Skipping meals, particularly breakfast,
contributes to fatigue, mood swings, and poor concentration. Healthy food choices (not
high in simple sugars) maintain blood sugar level, energy, and concentration of the body.
c. Know your limits and when you need to let go. Some problems are beyond our control.
If something cannot be changed, work at accepting it for what it is. Resist the urge to fix
the unfixable or try to control the uncontrollable. Sometimes a mantra helps: "It is what
it is, I just need to accept it." For things within your control, remember that change takes
time. If you are holding on and need to let go, journal about it.
d. Identify or create a nurturing place in your home. A rocking chair, a nice view, and a
soothing music are important components to a nurturing place. Twenty minutes of
spending in a rocking chair reduces both your physical pain and anxiety. It is like giving
yourself a hug. Music and nature sounds nurture our being and lifts our spirits.
e. Practice relaxation or meditation. Go to your nurturing place and listen to guided
relaxation tapes. Time spent in meditation or prayer allows your mind and body to slow
down and let go of the stress. Take a mental vacation in the midst of stress by relaxing
your body, shutting your eyes, and visualizing yourself in your favorite vacation spot or
quiet haven.
f. Escape for a while through meditation, reading a book, watching a movie, or taking a
short trip.

Self-compassion Therapy

Self-compassion is another way to counter stress. Kristin Neff (2012) has discussed self-compassion
in her article, "The Science of Self-Compassion."

"Self-compassion entails being warm and understanding toward ourselves when we suffer, fail, or
feel inadequate, rather than flagellating ourselves with self-criticism. It recognizes that being
imperfect and experiencing life difficulties is inevitable, so we soothe and nurture ourselves when
confronting our pain rather than getting angry when life falls short of our ideals. We clearly
acknowledge our problems and shortcomings without judgment, so we can do what is necessary to
help ourselves. We cannot always get what we want. We cannot always be who we want to be.
When this reality is denied or resisted, suffering arises in the form of stress, frustration, and self-
criticism. When this reality is accepted with benevolence, however, we generate positive emotions
of kindness and care that help us cope. Self-compassion recognizes that life challenges and personal
failures are part of being human, an experience we all share. In this way, it helps us to feel less
desolate and isolated when we are in pain."

Self-compassion Phrases

Neff provided self-compassion phrases when feeling stress or emotional pain, perhaps when you are
caught in a traffic jam, arguing with a loved one, or feeling inadequate in some way. It is helpful to
have a set of phrases memorized to help you remember to be more compassionate to yourself in the
moment. You can take a deep breath, put your hand over your heart, or gently hug yourself (if you
feel comfortable doing so), and repeat the following phrases:
  This is a moment of suffering.
 Suffering is a part of life.
 May I be kind to myself.
 May I give myself the compassion I need.

These phrases capture the essence of the three components of self-compassion. The first phrase
helps to mindfully open to the sting of emotional pain. (You can also just simply say "This is really
hard right now" or "This hurts.") The second phrase reminds us that suffering unites all living beings
and reduces the tendency to feel ashamed and isolated when things go wrong in our lives. The
third phrase begins the process of responding with self-kindness rather than self-criticism. The final
phrase reinforces the idea that you both need and deserve compassion in difficult moments. Be
experimental with the phrases. Other phrases that may feel more authentic in a given situation are:
"May I accept myself as I am," "May I forgive myself," or "May I learn to accept what I cannot
change." (Neff 2012)

Self-compassion and Emotional Well-being

One of the most consistent findings in the research literature is that greater self-compassion is
linked to less anxiety and depression. Of course, a key feature of self-compassion is the lack of self-
criticism, and self-criticism is known to be an important predictor Of anxiety and depression.
However, self-compassion still offers protection against anxiety and depression when controlling for
self-criticism and negative effect. Thus, self-compassion is not merely a matter of looking on the
bright side of things or avoiding negative feelings. Self-compassionate people recognize when they
are suffering, but are kind toward themselves in these moments, acknowledging their
connectedness with the rest of humanity. Self-compassion is associated with greater wisdom and
emotional intelligence, suggesting that self-compassion represents a wise way of dealing with
difficult emotions. For instance, self-compassionate people engage in rumination and think
suppression less often than those low in self-compassion. They also report greater emotional coping
skills, including more clarity about their feelings and greater ability to repair negative emotional
states. Self-compassion appears to bolster positive states of being as well. By wrapping one's pain in
the warm embrace of self-compassion, positive feelings are generated that help balance the
negative ones (Neff 2012).

Self-compassion, Motivation, and Health

Research supports the idea that self-compassion enhances motivation rather than self-indulgence.
For instance, while self-compassion is negatively related to perfectionism, it has no association with
the level of performance standards adapted for the self. Self-compassionate people aim just as high,
but also recognize and accept that they cannot always reach their goals. Self-compassion is also
linked to greater personal initiative—the desire to reach one's full potential. Self-compassionate
people have been found to have less motivational anxiety and engage in fewer self-handicapping.
behaviors such as procrastination than those who lack self-compassion. In addition, self-compassion
was positively associated with mastery goals (the intrinsic motivation to learn and grow) and
negatively associated with performance goals (the desire to enhance one's self-image) found on the
study of Deck in 1986. This relationship was mediated by the lesser fear of failure and perceived self-
efficacy of self-compassionate individuals. Thus, self-compassionate people are motivated to
achieve, but for intrinsic reasons, not because they want to garner social approval. (Neff 2012).
Self-compassion versus Self-esteem

Research indicates that self-compassion is moderately associated with trait levels of self-esteem as
one would expect, given that both represent positive attitudes toward the self. However, self-
compassion still predicts greater happiness and optimism as well as less depression and anxiety
when controlling for self esteem. Moreover, the two constructs differ in terms of their impact on
well-being. Also, self-esteem had a robust association with narcissism while self-compassion had no
association with narcissism. In contrast to those with high self-esteem, self-compassionate people
are less focused on evaluating themselves, feeling superior to others, worrying about whether or not
others are evaluating them, defending their viewpoints, or angrily reacting against those who
disagree with them. Self-esteem is thought to be an evaluation of superiority/inferiority that helps to
establish social rank stability and is related to alerting, energizing impulses and dopamine activation.
While self-esteem positions the self in competition with others and amplifies feelings of distinctness
and separation, self-compassion enhances feelings of safety and interconnectedness (Neff 2012).

Self-compassionate Letter

An example of a self-compassion exercise is the self-compassionate letter. This exercise has been
used in therapeutic programs. Below are the steps in doing the self-compassionate letter exercise as
provided by Neff (2012):

1. Candidly describe a problem that tends to make you feel bad about yourself, such as a
physical flaw, a relationship problem, or failure at work or school. Note what emotions come
up—shame, anger, sadness, fear—as you write.
2. Next, think of an imaginary friend who is unconditionally accepting and compassionate;
someone who knows all your strengths and weaknesses, understands your life history, your
current circumstances, and understands the limits of human nature.
3. Finally, write a letter to yourself from that perspective. What would your friend say about
your perceived problem? What words would he or she use to convey deep compassion?
How would your friend remind you that you are only human? If your friend were to make
any suggestions, how would they reflect unconditional understanding?
4. When you are done writing, put the letter down for a while and come back to it later. Then
read the letter again, letting the words sink in, allowing yourself to be soothed and
comforted.

Less Stress, Care More

We should be in control of the stress that confronts us every day. Otherwise, when we are
overwhelmed by stress, it can be detrimental to our health. Self-care and self-compassion are two
ways to positively confront stress. We should love and care for our self more and more each day.

Sources of Coping and Strength

Coping is the process of attempting to manage the demands created by stressful events that are
appraised as taxing or exceeding a person's resources (Lazarus & Folkman 1984). These efforts can
be both action-oriented and infrapsychic; they seek to manage, master, tolerate, reduce, or
minimize the demands of a stressful environment (Lazarus & Launier 1978).

Coping resources, in turn, affect coping processes, specifically ones marked by approach, such as
taking direct action or confronting emotional responses to a stressor, and ones marked by
avoidance, such as withdrawal or denial. Coping efforts may be adaptive or maladaptive, and the
form that coping processes assume affects how successful resolution of a stressor will be. Coping
Resources it has long been known that people with a diverse array of mental disorders, including
depression, schizophrenia, anxiety disorders, and autism lack coping resources for managing the
challenges of daily living.

Sources of Strength, a universally-recognized suicide prevention program, is designed to build socio-

ecological protective influences among youth to reduce the likelihood that vulnerable, at-risk
adolescents will become suicidal. The program trains adolescents to become peer leaders and
connects them with an adult advisor in the program. With support from the advisor, the peer
leaders conduct well defined messaging activities intended to change peer group norms influencing
coping practices and problem behaviors (e.g., self-harm, drug use, unhealthy sexual practices).
Specifically, these activities are designed to reduce the acceptability of suicide as response to
distress, increase the acceptability of seeking help, improve communication between youth and
adults, and develop healthy coping attitudes among youth.

Sources of Strength is also designed to positively modify the knowledge, attitudes, and behaviors of
the peer leaders themselves.

There are power dimensions to all .this, such as those found in gender. Contrary to stereotypes
about women being more expressive, Filipinas are actually more prone to dealing with stressful
situations through tiis (endurance) and kimkim (repression). Men, too, are expected to keep their
feelings in check, but more out of masculine values of strength and stoicism. Men are generally not
allowed to cry, much less to go into hysterics; and this probably helps to explain why more men
suffer from cardiovascular disease.

Many Filipinos will express their stress by complaining about recurring headaches, or abdominal
pains, accompanied by dizziness, nausea, fatigue. Doctors used to dismiss these as being all in the
mind, but it has become clear the physical pain and distress may be quite real, that the pent-up
stress is expressed through the body.

These vague symptoms have been labeled as "somatization syndrome," and are often hard to treat,
partly because medical professionals still haven't figured out the biological processes involved.
Culturally, too, people may attach labels that don't quite reflect the actual part of the body that's
affected, as when they say that they're suffering from nerbyos or "nerves." Nerbyos doesn't
necessarily mean being nervous; it's often hypertension or high blood pressure, for example, and a
health professional or caregiver may miss the problem.

The Filipino is so attached to home and hearth that we even have a term namamahay, missing
home, to describe a range of symptoms, from insomnia to constipation that plagues us when we are
away from home. That's stress too. And with men, given the cultural imperative of suppressing their
distress, we might expect nightmares, some with fatal endings.

To understand what is meant by the term self-compassion, it is useful to first consider what it means
to feel compassion more generally. When we experience compassion, we notice and are moved by
the suffering of others. Rather than rushing past a homeless man begging for change on your way to
work, for example, you might actually stop to consider how difficult his life must be. The moment
you see the man as an actual human being who is suffering, your heart connects with him
(compassion literally means "to suffer with;"). Instead of ignoring him, you find that you're moved by
his pain, and feel the urge to help in some way. And importantly, if what you feel is true compassion
rather than simply pity, you may say to yourself, "There but for the grace of God go I. If I'd been born
in different circumstances, or maybe had just been unlucky, I might also be struggling to survive.
We're all vulnerable." Compassion, therefore, presupposes the recognition and clear seeing of
suffering. It entails feelings of kindness, care, and understanding for people who are in pain, so that
the desire to ameliorate suffering naturally emerges. Finally, compassion involves recognizing the
shared 2 human condition, fragile and imperfect as it is. Self-compassion has exactly the same
qualities—it's just compassion turned inward.

Self-compassion entails being warm and understanding toward ourselves when we

suffer, fail, or feel inadequate, rather than flagellating ourselves with self-criticism. It recognizes that
being imperfect and experiencing life difficulties is inevitable, so we soothe and nurture ourselves
when confronting our pain rather than getting angry when life falls short of our ideals. We clearly
acknowledge our problems and shortcomings without judgment, so we can do what's necessary to
help ourselves. We can't always get what we want. We can't always be who we want to be. When
this reality is denied or resisted, suffering arises in the form of stress, frustration, and self-criticism.
When this reality is accepted with benevolence, however, we generate positive emotions of
kindness and care that help us cope.

Common Humanity one of the biggest problems with harsh self-judgment is that it tends to make us
feel isolated. When we notice something about ourselves we don't like, we irrationally feel like
everyone else is perfect and it's only me who is inadequate. This isn't a logical process, but a 3 kind
of distorted self-centeredness: focusing on our inadequacies gives us tunnel vision so that we can't
see anything else but our own feeble, worthless self. Similarly, when things go wrong in our external
lives, we feel that somehow other people are having an easier time of it, that our own situation is
abnormal or unfair. When our experiences are interpreted from the perspective of a separate self,
we have trouble remembering the similar experiences of our fellow humans (like the dying 84 year-
old man whose final words were "why me?") Self-compassion recognizes that life challenges and
personal failures are part of being human, an experience we all share. In this way, it helps us to feel
less desolate and isolated when we are in pain.

Mindfulness is a non-judgmental, receptive mindstate in which thoughts and feelings are observed
as they are, without suppressing or denying them. You can't ignore your pain and feel compassion
for it at the same time. Of course, you may think that suffering is blindingly obvious. But how many
of us, when we look in a mirror and don't like what see, remember that this a moment of suffering
worthy of a compassionate response? Similarly, when life goes awry, we often go into problem-
solving mode immediately without recognizing the need to comfort ourselves for the difficulties
we're facing.

Key Terms:

Stress - a biological and psychological response experienced

Coping - is a process of attempting to manage the demands created by stressful events that are
appraised as taxing or exceeding a person's resources.

Coping resources - can aid in this process; these resources include relatively stable individual
differences in optimism, a sense of mastery, and self-esteem, and in social support

Intrapsychic - being or occurring within the psyche, mind, or personality

Actioned-Oriented - leadership involves taking action and leading by example

Sources of Strength- is also designed to positively modify the knowledge, attitudes, and behaviors of
the peer leaders themselves.

Self-Compassion - entails being warm and understanding toward ourselves when we suffer, fail, or
feel inadequate, rather than flagellating ourselves with self-criticism.